Abstract
Purpose Pancreatitis can lead to systemic inflammatory response, but the relationship between lymphocyte changes and patients with pancreatitis remains unclear. In this study, we evaluated the feedback function of changes in peripheral lymphocyte subsets on the condition of patients with pancreatitis. Materials and Methods 131 acute pancreatitis (AP) patients and 11 chronic pancreatitis (CP) patients constituted the patients' group; 20 healthy individuals were enrolled as healthy controls (HC). Serum concentration of C-reactive protein (CRP), amylase, and lipase and the frequency and absolute number of many types of peripheral lymphocytes (including T, B, NK, CD16+/CD56+ T, CD4+ T, CD8+ T, CD4+CD8+ T, and CD4−CD8− T cells) were detected on admission and the seventh day of standard treatment. Besides, the length of hospital stay was recorded. Results The absolute number of all lymphocytes we studied decreased in patients with CP and in patients with almost all types of AP. The frequency change of lymphocytes varies among the different types of AP. During disease onset, B cell frequency correlated positively with CRP concentration and NK cell frequency correlated positively with amylase and lipase concentration. B cell frequency and CD4+ T cell absolute number were recovering towards normal after short-term treatment. The frequency of B cells and NK cells correlated positively with the length of hospital stay. Conclusions B cells and NK cells closely correlate with patients' condition and may help to diagnose AP more accurately and reflect treatment effect of AP in time, affecting the recovery speed of patients with M-AP, which may help physicians to better understand the pathophysiology of pancreatitis.
Highlights
Acute (AP) and chronic (CP) pancreatitis are pancreas inflammatory response that can be induced by a variety of factors including cholelithiasis, biliary blockage, alcohol, hyperlipidemia, autoimmunity, and other nonspecific factors [1, 2]
We found that in all types of pancreatitis including acute pancreatitis (AP), chronic pancreatitis (CP), mild AP (M-AP), severe AP (S-AP), biliary-AP (B-AP), unspecified-AP (U-AP), and alcohol and/or hyperlipidemia-AP (AH-AP) with the exception of B cells in S-AP and AH-AP, the absolute number of all other lymphocyte subsets was significantly reduced (Table 4), whereas the frequency change of lymphocytes varies depending on the type of pancreatitis
In patients with AP, B cell frequency and the ratio of CD4/CD8 were significantly elevated while NK cell frequency and DN T cell frequency were significantly reduced
Summary
Acute (AP) and chronic (CP) pancreatitis are pancreas inflammatory response that can be induced by a variety of factors including cholelithiasis, biliary blockage, alcohol, hyperlipidemia, autoimmunity, and other nonspecific factors [1, 2]. Lymphocytes act as important immunoregulatory cells and can secrete various cytokines to directly or indirectly regulate immune response. It has been reported that activated T cells and B cells play an important regulatory role in various inflammatory responses including pancreatitis [6]. Pietruczuk et al [7] revealed that there was a group of significantly activated lymphocytes in AP patients with enhanced ability to secrete Th2-type cytokines. Increased monocytes and reduced apoptosis-induced NK cells and CD4+ T cells were found in early AP [8]
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